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Abstract

Drawing on three sources, a 2013
qualitative study in four districts of Punjab province; a
targeted analysis of the baseline and end line surveys of
the Family Advancement for Life and Health (FALAH 2007-2012)
project; and the Pakistan Demographic Health Survey (PDHS)
of 1990-1991 and of 2006-2007, this study explores Pakistani
(especially Punjabi) couples' dynamics during their
decision processes on fertility intentions and practices,
along with community perceptions of male-focused
interventions as well as men's suggestions for future
intervention strategies. It finds that men in Punjab seem
now more concerned about their fertility intentions and
practices due to the financial challenges of raising large
families. This concern has not only increased spousal
communication about family size and contraceptive use but
has also encouraged Punjabi men to practice family planning.
Most men now realize that either they or their wives should
use family planning. It is the next step, however, of
translating intention into practice, which is a challenge.
Supply-side issues, including absence or paucity of family
planning services as well as poor quality of services
(including service providers' lack of capability to
manage side effects) are the main factors hindering
couples' adoption of family planning. Perceived or
experienced side effects of contraceptive methods are other
factors. Men's positive attitudes and their readiness
to be involved in family planning programs suggest that the
efforts of convincing men to use contraceptives have been
effective and this it is now time for direct reproductive
health interventions for men in Punjab. Yet heavy spending
on media campaigns may not be as effective as interpersonal
interventions. A focused effort to mobilize men through
male-specific interventions is likely to increase the demand
for contraceptives. These interventions have to be backed up
by improved supply of contraceptives and availability of
family planning services in accessible facilities.